Breastfeeding After a C-section

Unfortunately, c-sections and epidurals both contribute to breastfeeding difficulties. But, you are obviously committed so I am sure that like many women you will be able to overcome the challenge.

One thing is that if your baby has low blood sugar a good option it to put the baby to breast prior to giving a bottle. Putting the baby to breast then rechecking blood sugar often eliminates giving bottles. Hospitals that do not practice this way are not using good evidence in the protocols. I would talk with your pediatrician prior to the birth to check their (the hospital) practice protocols.

Secondly, if the baby does need a bottle you can try cup or syringe feeding. This means giving formula in a cup or using a small syringe to squirt the formula into the baby's mouth. This allows baby to get the formula without affecting their suck.

Also remember that a newborn baby's stomach is the size of a marble. The do not need much formula or breastmilk to be full. Many nurses will force feed newborns tons of formula and that can only cause problems (excessive spitting up and breastfeeding issues). You could insist on giving the baby a bottle yourself if it is necessary to avoid overfeeding. Your body makes colostrum in very small amounts that are usually perfectly adequate for baby.

Lastly, if baby does end up in NICU/ needing bottles, remember that every bit of stimulation on your breasts helps to bring in your milk. Don't give baby a pacifier, instead put him or her to the breast to satisfy the sucking urge, even if they just had a bottle. It is so tempting to sleep but try to pump on a regular, frequent schedule if baby cannot breastfeed. Remember that baby is far more efficient at getting milk out than a pump so what you see may not be what baby gets.

There are certain medications that can help with milk production, reglan and domperidone are two of them. I would recommend contacting an LC prior to giving birth and setting up a visit for after babe arrives. There is an LC on this board who seems very helpful, I think you may be able to do a search for her.

Good luck to you. I too have faced many breastfeeding challenges so I know what it's like to be there. Just remember that for thousands of years the human race survived on breastfeeding, so there's no reason to believe you can't overcome the challenges. Best wishes.

Adding:

I just wanted to make sure that it's clear that food cannot be given via IV. The IV fluids women are given in labor and sick people get in the hospital are just FLUIDs, there is no nutrition. There is something called TPN that providers nutrition but at the expense of kidney function. Giving nutrition (or breastmilk!) via IV will not be an option unless the baby is very sick and cannot eat anything by mouth.

You've already gotten excellent advice here! Just wanted to add that I too had a c-section with my 1st son and did not nurse him for 4 days while he was in the NICU (too many things attached to him). I started pumping the day after he was born and did so at least every 3 hours to try to get my milk to come in (also they gave it to him in a bottle). My son was able to nurse (thankfully) after 4 days and he took to it like a champ. However, even when my milk came in I was never really engorged. Despite this, I was able to nurse him exclusively for 6 months and then continued on til he was 18 months (with solids). He had plenty of milk and this was with me going back to work full time when he was around 10 weeks old (ugh!). Pumping at work and nursing at home was enough to keep him happy! Good luck with your upcoming birth! I H. you do not have to have another section because that definitely make bf harder but if you do then know that it is possible to succesfully breastfeed for however long you wish.

Having a Cesarean shouldn't cause you not to be able to breastfeed. Make sure they give you the baby while you are in recovery so that you can start right away. The first 24 hours or so your baby won't be hungry but you should offer the breast and allow the sucking to occur. The baby will only get drops of colostrum at this time but this sucking will help your milk come in. Once your breastmilk comes in breastfeed at least every two hours or as baby needs. Make sure the staff know that you will be breastfeeding and not to offer formula. If they are insistent talk to the LC to see if it is necessary. Other things are to drink lots of water, feed on demand, possibly take a nursing class prior to the birth, and seek help when needed. It sounds like you are determined and I H. things work out for you this time!!!

Your story is similar to mine. My milk never did come in with my first child- no engorgement, just drops. I ended up doing syringe feeding and supplementing with formula for 2 weeks and after trying to increase my supply with supplements went to formula only. My baby had extreme jaundice and was fatigued so that didn't help at all.

With my second I consulted a lactation person beforehand from a referral I got from a friend. This time I was the one who ha medical complications but my baby was fine. Once again no engorgement but I was able to do both formula and breast feeding. I breast fed for 4 months and was happy I did so, even though for the first 2 weeks I was pretty much bed ridden and had a catheter.
I contribute my being able to breastfeed this time due to the fact my baby had no problems, I had a great lactation consultant come to my house and I had the support of my husband.

Sending many blessings your way,
M. P

my first child was an emergency c-section and I immediately placed him on my breast as soon as I was in the recovery room... couldn't have been more than an hour after the delivery. my milk came in a few days later.. just as with a normal delivery. no problems at all. I didn't give him ANY formula to supplement.. no need to do that. the liquid that comes out of the breast right away before your milk comes in has all the nutrition that the newborn needs.
there's nothing you can do, as far as I know, besides drinking nursing mother's tea (whole foods) to make your milk supply come in. just rely on mother nature and feel confident that this time things will go well. but you have to nurse every couple of hours round the clock immediately after the birth!
also I think part of your issue the first time was giving the baby formula from a bottle. everything I've read says that if you give a baby a bottle, they won't want to nurse because it's so much easier to take a bottle than to nurse... I told the hospital when I checked in that there would be NO Formula at all and they marked that on my chart right away and didn't even suggest it... and I had no problems...

Good for you for wanting to do what you can to make it work! I had a c-section. My dd breastfed on demand (which meant that I put her to breast before she cried, just when I saw that she was rooting around and the first week she rarely went more than an hour between when she stopped her last feeding to when she started to nurse again). My milk didn't come in for 7 full days, the 8th day is when I got engorged. But all she had was the breast that first week (colostrum).

I agree with insisting (to the docs & staff) that you put the baby to breast first before formula (if they insist on formula). The baby belongs to you, not to the hosp, you are allowed to make decisions and choices for your baby. And if you have to do formula, use a small spoon, cup, or syringe so baby doesn't get used to sucking on a bottle.

To increase milk supply, stimulate via a good breast pump (medella pump in style or similar). Hospitals often have them to rent. Also, make sure you are hydrated! This helps a lot. Drink drink drink your water. Even if you are only getting a few drops when you pump, keep pumping frequently.

Get in touch with a local chapter of LLL (La Leche League) as they have books you can borrow and trained leaders that could be of great help as well. Good luck!

I'm so sorry you had a tough first experience with this! I was able to succesfully breastfeed my son after my c/s (he was breech) and I think there were a few key things that made this work well for me. Here they are:

1. Have your baby with you AT ALL TIMES. I had my c/s at Prentice and I was able to nurse my baby in the recovery room. My son was never out of my sight the entire time I was there (3.5 days). Don't let the nurses take it even "for some extra sleep for mom" - it's not worth it. Rooming in and feeding your baby on demand is the absolute #1 thing you can do to get this off to a good start.

2. Get support from an experineced friend, lactation consultant, doula, your mom, someone with a lot of experience successfully breastfeeding RIGHT AWAY - they can show you how to hold your baby and get him to latch correctly etc. With a c/s there are some different positions that might be easier than in front of you.

3. Get a boppy pillow or similar - bring it to the hospital with you.

4. Have some goals for the first few days. Day 1: Nurse 3-5 minutes per side every 1-2 hours (or whenever the baby seems to want it. Day 2: Nurse 5-7 minutes per side. Day 3: shoot for 10 minutes per side. Your baby may be VERY sleepy and you may have to work hard to keep him awake. At one point we resorted to a cool washcloth on my son's chest to wake him up enough to nurse. With any luck your milk will come in before you leave the hospital. YOu can tell when this happens because you'll hear your baby swallowing more loudly.

5. Don't use any artificial nipples. No bottles. No pacifiers. Baby can suck on your finger if he's feeling "sucky".
6. Have confidence in your body! This is also key I think. Don't have a doubt that your body is MADE to feed a baby. Everything will work out just fine for you.

Finally, I suggest you put your desire to breastfeed, room in, have your baby in recovery etc. into a birth plan and go through it with your doctor before the big day. You can create a c/s birth plan just like you do a "normal" birth plan, and this can make a huge difference as to how you feel about things afterwards.

Good luck with your second baby!

I would strongly advise going to some La Leche League meetings in your area. You can also get some great advice at http://forums.lalecheleague.org.

I have no experience with c-sections and breastfeeding, but did want to let you know that just because you do not pump much doesn't mean that you do not have milk. Pumps are no where near as efficient at milk removal as a baby is. So, just because you're pumping drops doesn't mean that you are not producing enough for baby.

Also, not every woman gets engorgement. Breast fullness is also not a sure sign of enough milk. The best way to tell if baby is getting milk is diaper output. At the newborn stage, baby should be having 4-6 wet/poopy diapers per day. If the baby is getting that, then you are producing enough milk for your baby.

Also, remember that breast milk is a supply/demand set-up. If you supplement your child, you are off-setting that supply/demand cycle. Demand feeding, whenever baby wants to nurse, you allow them to nurse, this tells your body that baby needs more.

I believe that most hospitals will honor the request that baby is brought to you immediately after birth (unless there are some over-riding medical circumstances to prevent it). The hospital should be told that under no condition should they give baby a bottle or pacifier because this baby will be nursing. Some babies will refuse the breast once they've bottle fed and vice versa.

Like I mentioned earlier...definitely seek some outside support with LLL and the website.

Good luck!

I had a c-section and my milk came in fine. it doesn't make a dif how u deliver, once the baby is born your body "knows" and produces the milk.

I, too, had a c-section. What I learned after being frustrated, is that I was only producing a few drops of milk even after a few days, is that in most women who have had a c-section, it takes longer for your milk to come in. The key to success is to both put the baby at the breast as much as possible and to pump in-between. Although it took several days, my milk finally did come in and was in abundance.

Secondly, my son had difficulty latching on. Something in me was determined to breastfeed this child, so I continued to put him at the breast, but also pumped and cup fed him to be sure that he would not experience nipple confusion.(I believe the reason he was not into latching on was the positioning I was using...because of the c-section it was painful to lay on my side. As soon as I had recovered enough to do this...he was nursing like it was his job!) This may seem overwhelming, but four weeks later he was breastfeeding perfectly. I continued to nurse him until he was 15-16 months old.

I absolutely do not regret the time and perseverance it took to achieve this. He is an extremely healthy child. (now 7 years old)

My advice is DO NOT give up...Breastfeeding is best for babies and unless medically can't be done is owed to our precious babies!

The most important thing with breastfeeding is supply and demand. The pump doesn't ALWAYS work for everyone, and yes, in the first few days you will only get tiny amounts. But your baby needs to feed asap after the birth and you need to put him to breast as often as possible in those first few days. I can understand that being difficult having a C section and then your boy being in NICU (my son was in the NICU for 4 days for the exact same reason). I had to call my nurse every time the nursery called and told me he was hungry and have them wheel me up....even though I had a vaginal birth, he was a big baby and it was VERY fast so I had quite a bit of recovery to do. It was hard to do cause I had no LC up there in NICU and my son wouldn't latch very well which lead to a month of struggling every time he tried to eat. The BEST thing is to have your baby with you as much as possible. If you have another C you could nurse the baby in bed (LC should be able to help teach you how to do this...it takes a little getting used to). If you can't do that then pump like mad. Like every 1 1/2 hours - 2 hours. If that STILL isn't working, it is possible that you have low levels of prolactin and there are some medications they can try to help with that. My Mom had this problem but didn't find it out till her 3rd child cause they just didn't know that much about it back then. You can also take herbs like fenugreek or tinctures for letdown. Don't let the nurses give the baby any artificial nipples because then the baby will learn to suck from a bottle instead of a breast...and they are very different. Even though my milk came in fine, this is the issue I dealt with that very nearly made me give up. If in a similar situation to last time, they should be able to give him nutrition via IV and then for supplemental feedings it should always be you nursing him. And gradually it should go less and less in the IV and more and more you. Have them call you when he needs a feeding if the baby is in the NICU. Also my nurses would take anything I could pump and give it to him (via bottle ugh) but I would think that that could be given via IV as well. It has a lot to do of how supportive the staff REALLY is about BF or if they are just giving it lip service.

Good luck with this one! I am also due in March and hoping feeding this one will be a much easier experience!

Would just like to say my heart goes out to you. I also had a c-section, for different reasons, and could not get my son to nurse. I didn't have problems with my milk supply... but it was so frustrating! I think being able to nurse your child immediately will help?